Urinary free cortisols

Investigation Protocol

Indication

This is a first line screen for Cushing's syndrome and is usually performed with a low dose dexamethasone suppression test.

Preparation

The patient may eat and drink normally prior to the test. Written instructions must be given to the patient prior to performing this test to ensure that the 24 hour collections are performed accurately. Two plain 24 hour collection bottles should be provided to the patient in advance.

Procedure

Patients are informed to choose two convenient days to perform their urinary collections. The two days need not necessarily be consecutive.

Patients are advised to empty their bladder into the toilet normally on waking on the morning that they start a collection and note the time.

From that time onwards, all urine passed that day should be collected into a plain collection bottle. All urine passed during that night should also be collected.

The patient should set an alarm if necessary to wake them by the same time the following morning. That morning, the patient should empty their bladder and collect this as the final sample into the same bottle as from the previous day. This means that they start and finish the collection with an empty bladder at the same time of day.

The test should then be repeated on a second day and both collections brought in together for analysis.

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Patient information sheet

Urinary free cortisols

Your doctor has asked us to coordinate a urine test to measure some very specialised steroid hormones, which are produced in glands called the adrenals.

It is very important that the test is completed on two days, and that every time you pass urine it is all collected as this will affect the results of your test.

First identify a day which is suitable: it is probably easiest if there is a day you are not planning to go out on to perform this test. You will need to repeat the test on two whole days, but they need not be consecutive if this is less convenient. For example, you might find it easier to perform on two sundays in a row.

Please take all your medication as normal and you may also eat and drink as normal on the day of this test. The easiest way to start is to empty your bladder into the toilet normally when you wake up, on the morning that you start a collection and note the time. From that time onwards, all urine passed that day should be collected into a plain collection bottle. All urine passed during that night should also be collected.

We recommend that you set an alarm if necessary to wake you up by the same time the following morning. That morning, you should empty your bladder but collect this as the final sample into the same bottle as from the previous day. This means that you start and finish the collection with an empty bladder at the same time the next day.

The test should then be repeated on a second day, and both collections may be brought in together for analysis.

If you have any queries about the test, please contact:

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